The resilient city

1222121819 Leading the way: BMC commissioner Iqbal Singh Chahal. BMC’s oxygen management has become a model of efficiency | Getty Images

ON MAY 10, Mumbai’s municipal commissioner, Iqbal Singh Chahal, reportedly said even if there was a national lockdown, there was no need for it to be implemented in Mumbai. His optimism stemmed from a sharp decline in daily Covid-19 cases across the city—from 10,000 a month ago to under 2,000. The city’s daily test positivity rate, too, came down to 7 per cent from over 25 per cent in the first week of April. On May 9, Mumbai did not report a single death related to Covid-19. Exactly a month back, 31 people had died in 24 hours.

At a time when Covid patients across the country, especially in the national capital, are struggling to get oxygen, the Brihanmumbai Municipal Corporation’s oxygen management has become a model of efficiency. The Bombay High Court suggested that administrators from within and outside Maharashtra emulate the “Mumbai model” (the situation in Pune is particularly concerning and cases are on the rise). The Supreme Court, too, hailed the BMC for its “remarkable work” and prodded the Delhi government and the Centre to consult Chahal.

“The kind of free hand I have is not easy to come by,” Chahal told THE WEEK. “You have to have full power [to take and implement decisions].” Since he took charge in May last year, the 1989 batch IAS officer has been at the top of his game, especially in communication. He would personally send messages to journalists daily, updating them about policy changes and statistics.

The corporation used social media to send minute-by-minute updates on vaccination slots and bed availability to its five lakh-plus followers, and to respond to calls for help and complaints, answer queries, and bust rumours and fake circulars. The plan to fight Covid-19 was executed seamlessly throughout the multiple levels of the bureaucratic chain. It was done with the right mix of centralised policy and decentralised execution at the ward level, across the city’s 24 wards.

Perhaps the most important aspect of the BMC’s Covid management infrastructure has been its dashboard. The data uploaded on the web link includes real time status of ICU and ventilator beds, beds with and without oxygen, containment measures, daily statistics, contact tracing and ward-wise Covid positive cases. It is accessible to all—citizens, hospitals and the administration.

Nagpur emulated it to contain and effectively manage the dire Covid-19 situation there a few weeks back. Ram Joshi, additional municipal commissioner, Nagpur, said that they had been in touch with the Mumbai commissioners long before the High Court had suggested it. The NMC also took from Mumbai the concept of hiring marshals and sending them across the city to enforce masking and social distancing.

The best example of decentralisation in the BMC’s Covid management is the ward war room. It is an independent entity which has been given the authority to decide bed allocations, patient admissions and ambulance availability. Wards are also free to spend without approval from the top. Akash Kadam and his team of volunteers take more than 2,000 calls a day at the war room of the G-North ward, which includes Dharavi. “We are a 24x7 contact point for all the residents in this ward with respect to their Covid-related issues,” said Kadam.

The corporation’s oxygen management system has a round-the-clock oxygen team, which includes six IAS officers. Robust planning to ensure oxygen sufficiency was started on a war footing after a harrowing experience in April. “I will never forget April 16-17, when around midnight, six hospitals ran out of oxygen and we were in panic mode,” said Suresh Kakani, additional municipal commissioner. “Between 1am and 5am, we shifted 168 patients from six civic hospitals across the city to our jumbo centres to save their lives. It could have ended in a disaster.” In that fortnight, active cases in Mumbai had peaked at 92,000.

P. Velrasu, additional municipal commissioner, said one reason why Mumbai had SOS calls for oxygen in April was that hospitals had not checked whether suppliers could provide extra oxygen when the occupancy of oxygenated beds increased. The regular supply, which normally lasted for 16 hours, was sufficient only for 10 to 12 hours and the refill schedule remained unchanged, he explained.

The corporation already had data about storage capacity and supply, from a resource mapping and inventory accounting exercise done in May 2020. “We realised that we needed more oxygen storage capacity in hospitals to cater to the higher usage,” said Velrasu. “We installed large, additional cryogenic tanks in most hospitals within 40 days; this normally takes more than three months.”

Mumbai has shown its resilience time and again. Now, when faced with a looming oxygen crisis, it responded by changing its largely temporary, cylinder-based system to a centralised, permanent, storage-based system.

Dead count

By Dnyanesh Jathar

Is the Brihanmumbai Municipal Corporation underreporting Covid-19 cases and deaths in the city? Devendra Fadnavis, leader of the opposition in the Maharashtra assembly, is convinced it is. The former chief minister has accused the BMC of window-dressing the numbers.

In a letter to Chief Minister Uddhav Thackeray, Fadnavis alleged that Covid-19 deaths were being registered as deaths due to other reasons. He claimed that 1,773 people died in Mumbai between February 1 and April 30 and 683 were shown as deaths due to other reasons. The percentage of deaths due to other reasons in the second wave was around 39 per cent in Mumbai, while it was 0.7 per cent in the rest of Maharashtra, he pointed out.

Fadnavis also accused the BMC of reducing the number of tests carried out and of opting for rapid antigen tests over RT-PCR tests in order to drive down the positivity rate. The BMC issued a statement calling his allegations baseless. It also said that the number of tests had increased from 4.44 lakh in January to 13.32 lakh in April.

Senior Congress leader Sachin Sawant said that the Supreme Court’s praise of the BMC seemed to have given Fadnavis a “stomach ache”. He suggested that Fadnavis pay attention to the false statistics being released by BJP-ruled states like Gujarat.